II. Mechanism

  1. Recombinant Parathyroid Hormone
  2. Significant bone anabolic activity

III. Indications: Severe Osteoporosis

  1. Women, postmenopausal, with severe bone loss
  2. Men with Osteoporosis and high risk of Fracture
  3. Osteoporosis refractory to Bisphosphonates

IV. Dose

  1. Teriparatide 20 mcg SQ daily for up to 2 years
  2. Consider restarting bisphosphonate after Teriparatide course is completed
    1. Black (2005) N Engl J Med 353(6):555-65 [PubMed]

V. Efficacy

  1. BMD increases 5.9% at spine and 1.5% at femoral neck
  2. Reduced risk for osteoporotic Fractures
    1. Neer (2001) N Engl J Med 344:1434-41 [PubMed]

VI. Contraindications

VII. Adverse Effects

  1. Common
    1. Orthostatic Hypotension
    2. Transient Hypercalcemia
    3. Nausea
    4. Arthralgia
    5. Leg Cramps
  2. Uncommon (identified in rat studies)
    1. Osteosarcoma

VIII. Precautions

  1. Do not use with bisphosphonate
  2. Use limited to 2 year maximum

IX. Resources

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Related Studies (from Trip Database) Open in New Window

Cost: Medications

forteo (on 5/2/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
FORTEO 600 MCG/2.4 ML PEN INJ $1,208.87 per ml

Ontology: Teriparatide (C0070093)

Definition (MSH) A polypeptide that consists of the 1-34 amino-acid fragment of human PARATHYROID HORMONE, the biologically active N-terminal region. The acetate form is given by intravenous infusion in the differential diagnosis of HYPOPARATHYROIDISM and PSEUDOHYPOPARATHYROIDISM. (Reynolds JEF(Ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex, Inc, Englewood, CO, 1995)
Concepts Hormone (T125) , Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH D019379
SnomedCT 425438001, 398823001
English hPTH (1-34), Human Parathyroid Hormone (1-34), TERIPARATIDE @ @ UNIDENTIFIED, TERIPARATIDE UNIDENTIFIED, HPTH 001 034, Teriparatide (substance), Teriparatide, Human PTH (1-34), (1-34)-Human Parathyroid Hormone, Teriparatide [Chemical/Ingredient], parathyroid teriparatide, teriparatide (medication), teriparatide, Teriparatide (product), TERIPARATIDE
Swedish Teriparatid
Czech teriparatid
Spanish teriparatida (sustancia), teriparatida (producto), teriparatida, teriparatide, Hormona Paratiroidea Humana (1-34), hPTH (1-34), Teriparatido
Finnish Teriparatidi
French hPTH (1-34), Hormone parathyroïdienne humaine (1-34), Tériparatide
Russian TERIPARATID, PARATIREOIDNYI GORMON (1-34) CHELOVEKA, ПАРАТИРЕОИДНЫЙ ГОРМОН (1-34) ЧЕЛОВЕКА, ТЕРИПАРАТИД
Japanese ヒト副甲状腺ホルモン(1-34), テリパラチド, 酢酸テリパラチド, フォルテオ, テリパラチド酢酸塩
Italian Ormone paratiroideo umano (1-34), hPTH (1-34), Teriparatide
German HPTH 001 034, Humanes Parathormon (1-34), Teriparatid, hPTH (1-34)
Polish Teryparatyd, hPTH 1-34, Hormon przytarczyc ludzki 1-34
Norwegian hPTH (1-34), Teriparatide, Humant paratyroideahormon (1-34)
Portuguese Hormônio (1-34) da Paratireoide Humana, Hormônio Paratireóideo Humano (1-34), Hormônio (1-34) Paratireóideo Humano, hPTH (1-34), Teriparatida

Ontology: Forteo (C1170286)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH D019379
English Lilly Brand of Teriparatide, Teriparatide Lilly Brand, forteo, Forteo
French Forteo
German Forteo
Norwegian Forteo